The Reauthorized Workforce Investment Act of 1998 (WIA) is one of many legislative reforms since the inception of nationwide job training and job search assistance programs more than six decade ago. The goal: better respond to the workforce development needs of businesses, job seekers and provide the job skills necessary to obtain such employment opportunities.

America has long been served an alphabet soup of failed federal and state training programs masked by endless statistical shams and lack of oversight. With each new administration, a new veneer, wider loopholes allowing fraud and abuse, conflicting rules and administrative structures remain the hallmarks of this multi-billion dollar boondoggle. If you think NH is immune to this beehive of activity, think again.

On a local level job training programs are identified as "eligible training providers" marketed by "One Stop Career Centers" to seekers of training who are awarded $4K grants and must choose from a "list" licensed and approved by both NH Postsecondary Education Commission and Workforce Opportunity Council (WOC). And some endorsed by NH Department of Health and Human Services.

The underbelly of this system operates in a pinky-ring mob-connected mentality. In an arena where profits and bribes take center stage these proprietary programs don't operate in a vacuum. There's a "front person" delivering a well scripted sales pitch, a trumped up dog and pony show, some "shills" paid to endorse along with the license and approval of above state and federal agencies. Often instructors willingly participate in luring students.

The Healthcare Industry is most harmed by tinsel training. For example, for 4K you get a short program containing a bloat of word and excel classes peppered with a few intro medical type courses leaving students ill prepared to land employment for what the program advertises: "Medical Billing and Coding Specialist" or "Office Administrator". Hiring managers viewing resumes containing alphabet bargain bin certification along with the terms "Coding Specialist" or "Administrator" laughingly reject applicants while mentally wiping these programs from their short lists. According to Naomi Preble of Rochester, former student of BSTI Blended Solutions stated, "I no longer list the name of the school on my resume as it is more a liability than a benefit in the job search."

Here in lies the problem: If a program on "the list" is not chosen by an unemployed individual their tax dollars in the form of an ITA voucher is forfeited and they are not allowed to spend the voucher on industry preferred training. Since Medical Coders do not require a license this leaves ample room for programs on "the list" to truncate and even omit vital courses from their offerings, still at the approval of Postsecondary Commission.

A Compliance Officer from a local Healthcare System testified at HB1211 in January 2008 that physicians at her hospital will not allow hiring from these programs. Medical Coders shield physicians from OIG audits, prevent the loss of millions in revenue due to improper coding and affect worldwide morbidity and mortality statistics. The ramifications to you as a patient are enormous. HB1211 was sponsored to have coursework aligned with employer requirements. NH Legislators did not pass HB1211 leaving consumers further scammed.

In addition, these speedy programs offer NOdiploma, NO credits, NO advisory board, NO accreditation, NO continuing education units and NOdirect paid vendor affiliation with AAPC or AHIMA; all factors impacting employers turning away applicants. And the calamity doesn't stop there. A deeper shade of fraud revealed a program owner fabricates written success stories as lures indicating students landed jobs in local hospitals as Medical Coders right after the training; a pathetic way to rip-off the unemployed who have no lobbyists. The school remains licensed by Postsecondary.

Ellen Wallpe, CPC, General Surgery Practice Manager in Dover stated during her testimony of HB1211 "I would not place a short term trained person in any part of the revenue cycle in my office, our physicians want those trained by PMCC instructors from the Academy of Professional Coders or instructors approved by the American Health Information Management Association."

SB173 prevents vouchers from being used to obtain training from these preferred organizations; therefore, you cannot get on the "A" list with your own tax dollars.

In other professions, standardization has occurred thru legislation, educational changes, public demand and media attention. For example, uniformity exists in the nursing field focusing on responsibilities that pose a risk to patients if performed by unqualified persons. Although Health Information Management personnel do not provide direct care, coding of diagnosis, procedures and services can influence and affect subsequent treatment and or reimbursement decisions which affect patient care.

After complaining to the Vice President of WOC about the truncated coursework of one program, I was told "well, that's just the way it is". The Licensing and Approval Administrator for Postsecondary Commission testified at HB1211 "I just don't have time to look into these complaints". I received her document stating: "Postsecondary voted against HB1211, but we care". After licensing for 3 yrs. the annual renewal application that allowed a Manchester training provider to operate a program in a backyard storage shed in Rye absent of fire and building code, no windows, no elevator, no ramp leaving the disabled unwelcome to this federal and state sponsored location where state caseworkers steered the unemployed, one would wonder if this is also an expression of caring. This location continues to enroll despite a documented student complaint to WOC and Postsecondary regarding a web-cam in the bathroom.

Massachusetts fairs better at squeezing out unscrupulous gigs and placing students in safe environments. For example, state over-seers actually make site visits with little notice to question instructors then corral students interviewing them individually, I am told. In contrast, one or more NH licensing agencies offer up different solutions; the paper shuffle, a blind eye to marketing abuses, and unqualified instructors within these programs according to dozens of prior and current students who, scammed beyond belief, now turn to non-governmental advocacy groups to detail their complaints.

HB1331, a welfare reform bill passed in 2006 requires recipients to enroll in job training before returning back to their welfare status. At $4K a pop you can see why training providers cruise the local "One Stop" center sizing up the school of fish. When entitlements pay more than a job will following training it's the taxpayer who foots the bill for able bodied citizens to belly up into their lazy-boys. And while the unemployed displaced workers may require training to land the next job it is usually the employer that trains new hires and gets either tax credits or payments thru the NH Job Training Fund, leaving some proprietary training gigs unnecessary and worthless.

Buyers beware strategies firmly in place cannot be understated especially in this down-trodden economy. Contact HCAudit@aol.com for assessment tools.

Johnna Grzywacz, CPC, is a credentialed medical coder specializing in audits, compliance and education. She is also a freelance writer and workshop leader on issues related to Health Information Management, and she resides in Southern NH with her husband, Rich.